Magnitude, maternal and perinatal outcomes of hypertensive disorders of pregnancy at st luke catholic hospital, wolisso, Ethiopia

Abstract

Background: Hypertensive disorders complicating pregnancy seriously affect the safety of the mother and fetus during pregnancy. Very few studies have explored hypertensive disorders of pregnancy in Ethiopia, even though this disease has been associated with adverse maternal and perinatal outcomes. Objectives: The study was to determine the prevalence, maternal complications, perinatal outcomes and risk factors associated with the Hypertensive Disorders of Pregnancy (HDP) who were seen at St Luke Catholic Hospital from 01 January 2011 to 31 December 2013. Methods: Facility based cross-sectional retrospective study was conducted by reviewing available data or hospital records of pregnant mothers who were admitted to the labor and maternity wards from 01 January 2011 to 31 December 2013, of Wolisso St Luke catholic hospital. The data were collected using a structured check list from March 2014 to April 2014 and analyzed using SPSS for windows version 16.0, OR and 95% CI were calculated. P-value <0.05 was considered statistically significant. Results: From a total of 9327 deliveries during the reference time period, 345 Hypertensive cases were identified, of which only 260 (75.4%) booked for antenatal care. The overall prevalence was 37 per 1000 deliveries. The maximum age was 41years, with a median of 26 years and a mean of 26.90±5.49 (±SD) years. Among the cases 307(89%) were younger women of the age group 18-35 years. Hundred seventy four (50.4%) of the 345 cases were Primigravida. There was great difference between in the distribution of HDP amongst the residential areas with higher number of rural cases compared to urban cases (p=0.05). Along the spectrum of the condition, 107(31%) mild pre-eclampsia, 138(40%) sever preeclampsia, 70(20.3%) eclampsia, and 12(3.5%) superimposed pre-eclampsia, 15(4.4%) and 3(0.9%) cases who had pregnancy induced hypertension (PIH) and chronic hypertension in their previous pregnancies respectively. Maternal complications included abruption placenta 13(12.5%), multiple organ failure 1(0.96%), Post partum hemorrhage 30(28.8%), 1(0.96%) acute renal failure (ARF); pulmonary edema 2(1.9%), infection 18(17.3%), HEELP syndrome 38(36.5%), Premature rupture of membrane 1(0.96%) and maternal death 5(1.4%). Perinatal outcomes included 181(52.5%) preterm deliveries, 161(46.7%) low birth weight babies, 37(10.7%) stillbirths and 21(6.1%) neonatal death.